scholarly journals Study on the Design and Optimization of a Portable Monitoring and Auxiliary Treatment Device for Upper Extremity Lymphedema–Focus on the Rehabilitation Function of the Device

Author(s):  
Xue Yanmin ◽  
Zhang Xuyang ◽  
Yan Wen ◽  
Yu Suihuai ◽  
Li Sinan

Female patients suffer from the risk of upper limb lymphedema after breast cancer removal surgery. At present, the detection and the adjuvant treatment of this disease are not convenient enough, leading to delay of the disease and increase in the burden of patients. This paper presents a portable monitoring and treatment device for upper extremity lymphedema, enabling patients to monitor the symptoms of upper limb lymphedema and auxiliary rehabilitation. This design utilizes the arm circumference measurement and contrast method to realize symptom monitoring. The device realizes auxiliary rehabilitation using the regional pressure method to imitate traditional manual lymphatic drainage technology. According to the MRI images of volunteers’ upper limbs, the upper arm and forearm’s finite element models are reconstructed in ANSYS. The static simulation experiment is completed. The working mode and parameter design of each rehabilitation module of the device are obtained. The experimental results show that the integrated design principle of monitoring and treatment proposed in this paper has good feasibility, has auxiliary rehabilitation effect, and meets the principle of human comfort. The device can help patients find lymphedema in time and implement auxiliary treatment, which can effectively avoid the further deterioration of lymphedema.

2017 ◽  
Vol 31 (2) ◽  
pp. 5-15
Author(s):  
Rafał Sapuła ◽  
Joanna Braniewska ◽  
Ryszard Weremczuk ◽  
Marta Wolanin ◽  
Joanna Sapuła

Abstract Introduction: Breast cancer constitutes 10.9% of all new cases of tumours registered in the Polish National Cancer Registry. Post-mastectomy lymphoedema of the upper limb is the most common post-operative complication. The aim of the study was to evaluate the effectiveness of selected physiotherapeutic methods in the treatment of post-mastectomy lymphoedema. Material and methods: The study included 90 post-mastectomy patients in Stalowa Wola, Zamość and Tyczyn in the period from January 2014 to July 2016. The patients participated in two-week outpatient physiotherapy. In order to assess the effectiveness of lymphoedema treatment, circumferences of upper extremities were measured before and after physiotherapy. The results were then statistically analysed. Results: The majority of the subjects had undergone mastectomy within a period shorter than 5 years before. It was noted that the post-mastectomy upper limb had a significantly smaller circumference after physiotherapy than before physiotherapy (p<0.001). The study revealed no differences in the measurements of arm circumference with regard to the time since the mastectomy was performed. According to the patients, manual lymphatic drainage was the most effective type of physiotherapy treatment (p=0.04). Statistical analysis revealed significantly smaller arm circumferences after physiotherapy than before physiotherapy in patients treated 2-3 times (p=0.001) compared to patients who underwent either fewer or more treatments at the same time. Conclusions: 1. Two-week physiotherapy treatment proved to be the most effective in reducing lymphoedema in the arm area. 2. The period since the performance of the mastectomy had no impact on the effectiveness of lymphoedema treatment. 3. According to the post-mastectomy patients, manual lymphatic drainage was the most effective type of lymphoedema treatment. 4. Applying 2-3 physiotherapeutic procedures at the same time showed the best results.


2020 ◽  
Vol 7 (5) ◽  
pp. 1562
Author(s):  
Jitesh Tolia ◽  
Arvind Bhatt

Background: Arterial disorders of the upper extremity are much less common than those of the lower extremity, but when they result in symptoms of acute or chronic ischemia, surgical or endovascular techniques for upper extremity revascularization may be needed. This study presents a review of the epidemiology, aetiology, and clinical characteristics of upper limb ischemia.Methods: The records of 70 patients with upper limb ischemia who underwent treatment from were retrospectively reviewed.Results: A total of 44 patients were diagnosed by CT. Other diagnostic methods and tools used were conventional angiography and duplex ultrasound. Four cases were diagnosed solely on the basis of a medical history and physical examination. A total of 56 surgeries were performed. Rest of the 14 patients went under conservative therapy. The operations included embolectomy and thrombectomy using a Fogarty balloon catheter (n=32), bypass surgery using the great saphenous vein (n=10), percutaneous catheter-directed thrombolysis (n=8), and primary repair (n=4). Patients with Raynaud’s phenomenon or Burger’s disease were either treated with medication only (n=14) or with sympathectomy (n=2).Conclusions: The duration of symptoms in cases of upper limb ischemia may vary from two hours to a year, depending on the aetiology and severity of the illness. Many debates have addressed whether the time gap between the onset of symptoms and treatment predicts long-term arm function.


Sensors ◽  
2021 ◽  
Vol 21 (23) ◽  
pp. 7884
Author(s):  
Celia Francisco-Martínez ◽  
Juan Prado-Olivarez ◽  
José A. Padilla-Medina ◽  
Javier Díaz-Carmona ◽  
Francisco J. Pérez-Pinal ◽  
...  

Quantifying the quality of upper limb movements is fundamental to the therapeutic process of patients with cerebral palsy (CP). Several clinical methods are currently available to assess the upper limb range of motion (ROM) in children with CP. This paper focuses on identifying and describing available techniques for the quantitative assessment of the upper limb active range of motion (AROM) and kinematics in children with CP. Following the screening and exclusion of articles that did not meet the selection criteria, we analyzed 14 studies involving objective upper extremity assessments of the AROM and kinematics using optoelectronic devices, wearable sensors, and low-cost Kinect sensors in children with CP aged 4–18 years. An increase in the motor function of the upper extremity and an improvement in most of the daily tasks reviewed were reported. In the population of this study, the potential of wearable sensors and the Kinect sensor natural user interface as complementary devices for the quantitative evaluation of the upper extremity was evident. The Kinect sensor is a clinical assessment tool with a unique markerless motion capture system. Few authors had described the kinematic models and algorithms used to estimate their kinematic analysis in detail. However, the kinematic models in these studies varied from 4 to 10 segments. In addition, few authors had followed the joint assessment recommendations proposed by the International Society of Biomechanics (ISB). This review showed that three-dimensional analysis systems were used primarily for monitoring and evaluating spatiotemporal variables and kinematic parameters of upper limb movements. The results indicated that optoelectronic devices were the most commonly used systems. The joint assessment recommendations proposed by the ISB should be used because they are approved standards for human kinematic assessments. This review was registered in the PROSPERO database (CRD42021257211).


2011 ◽  
Vol 24 (4) ◽  
pp. 386 ◽  
Author(s):  
Lucinda M. Dale ◽  
Elena Bolin ◽  
Heather Howearth ◽  
Megan Painter ◽  
Ashley Pickett ◽  
...  

2021 ◽  
pp. 154596832110702
Author(s):  
Jake Rydland ◽  
Stephanie Spiegel ◽  
Olivia Wolfe ◽  
Bennett Alterman ◽  
John T Johnson ◽  
...  

Background Most of the current literature around amputation focuses on lower extremity amputation or engineering aspects of prosthetic devices. There is a need to more clearly understand neurobehavioral mechanisms related to upper extremity amputation and how such mechanisms might influence recovery and utilization of prostheses. Objective This scoping review aims to identify and summarize the current literature on adult traumatic upper limb amputation in regard to recovery and functional outcomes and how neuroplasticity might influence these findings. Methods We identified appropriate articles using Academic Search Complete EBSCO, OVID Medline, and Cochrane databases. The resulting articles were then exported, screened, and reviewed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. Results Eleven (11) studies met the study criteria. Of these studies, 7 focused on sensory involvement, 3 focused on neuroplastic changes post-amputation related to functional impact, and 1 study focused on motor control and learning post-amputation. Overall, these studies revealed an incomplete understanding of the neural mechanisms involved in motor rehabilitation in the central and peripheral nervous systems, while also demonstrating the value of an individualized approach to neurorehabilitation in upper limb loss. Conclusions There is a gap in our understanding of the role of neurorehabilitation following amputation. Overall, focused rehabilitation parameters, demographic information, and clarity around central and peripheral neural mechanisms are needed in future research to address neurobehavioral mechanisms to promote functional recovery following traumatic upper extremity amputation.


2021 ◽  
pp. 409-434
Author(s):  
David J. Shewring

Fractures of the phalanges and metacarpals are the most common fractures of the upper limb and account for 10% of all fractures. Along with fractures of the carpal bones, they represent 55% of upper extremity fractures. Although over the last few decades there has been an increased tendency to treat hand fractures with internal fixation, the vast majority of these fractures are stable and can (and should) be treated non-operatively. If surgical fixation is considered, then it must be appreciated that some hand fractures, particularly those affecting the proximal phalangeal shaft and intra-articular fractures, can be unforgiving. Fractures treated poorly, using inappropriate equipment in inexperienced hands can lead to irretrievably poor outcomes. Good or perfect results can be obtained with surgical fixation, but these demand careful planning with consideration of all the various methods in the surgical repertoire. The best, and possibly the only opportunity to obtain a good result is at the first surgical intervention and so those fractures requiring fixation should not be treated by unsupervised inexperienced surgeons. It is preferable to delay fixation by a few days until the best expertise is available.


2018 ◽  
pp. 219-236
Author(s):  
Adam Zybulewski ◽  
Ilya Livshitz ◽  
Bhumika Patel ◽  
Aaron Fischman

This chapter evaluates the spectrum of pathologic diseases that affect the upper-extremity arteries, their clinical manifestations, imaging characteristics, and treatment options. We review the role of surgical and endovascular intervention for the treatment of acute upper limb ischemia (AULI) and chronic upper limb ischemia (CULI), the clinical and imaging findings associated with Raynaud’s phenomenon, hypothenar hammer syndrome, distal hypoperfusion ischemic syndrome (DHIS), thromboangittis obliterans (TOA), thoracic outlet syndrome (TOS), giant cell arteritis, Bechet’s disease, radiation arteritis, and traumatic arterial injury, including compartment syndrome and pseudoanuerysm formation. Finally, the evolution of upper-extremity arterial access and use of transradial access (TRA), including benefits and risks, technique, and complications, are discussed.


2010 ◽  
pp. 873-882
Author(s):  
George Samandouras

Chapter 17.2 covers nerve injuries of the upper extremity, including brachial plexopathies and upper limb mononeuropathies.


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